Cognitive approach to treating depression

Question 1

What is cognitive behaviour therapy?

Answer 1

• a method for treating mental disorders based on cognitive and behavioural techniques

Question 2

Outline Becks cognitive therapy

Answer 2

• identify automatic thoughts about world, self & future (negative triad)
• thoughts must be challenged directly
• CT therapy helps to test the reality of clients negative beliefs
• therapists sets them homework e.g. diary keeping (when they enjoyed an event) = referred to as the ‘client as scientist’ as they gather data
• therapists uses this as evidence to prove clients statements are incorrect (cognitive restructuring)

Question 3

Outline Ellis’s rational emotive behaviour therapy

Answer 3

• REBT extends the ABC model to an ABCDE model
  -D =dispute
  -E = effect
• Central technique is to identify & dispute negative/irrational thoughts e.g. utopianism
• disputing involves a vigorous argument

Question 4

What are the some methods Ellis identified of disputing?

Answer 4

• logical argument - are beliefs logical conclusions from information/facts available
• empirical argument- is there evidence to support negative belief
• pragmatic argument - are the thoughts useful to you

Question 5

What is behavioural activation?

Answer 5

• depressed individuals usually isolate which may worsen symptoms
• goal of BA is to work with depressed individuals to gradually reduce avoidance & isolation & increase engagement in activities that improve mood
• e.g. exercise, going out to dinner

Question 6

What is a strength of CBT for treating depression?

Answer 6

• evidence for the effectiveness of CBT for treating depression
• March et al > compared CBT to antidepressant drugs and also to a combination of both treatments when treating depressed adolescents
• after 36W 81% of the CBT group, 81% of antidepressant group & 86% of CBT plus AD group significantly improved in symptoms
• CBT just as effective on own
• NHS first choice of treatment

Question 7

What is a limitation of CBT for the treatment of depression?

Answer 7

• lack of effectiveness for severe cases of depression and clients with learning disabilities
• severe cases= clients cannot motivate themselves to engage with cognitive work of CBT (may not pay attention)
• unsuitable for treating depression in clients with LD due to complex rational thought required
  Sturmey- any form of psychotherapy not suitable for people with LD
• limited in its application for who it can treat

Question 8

What is a counter point to the fact that CBT is not effective for people with learning disabilities & severe cases of depression?

Answer 8

• recent evidence challenges this
• Lewis & Lewis > concluded CBT was effective as AD and behavioural therapies for severe depression
• Taylor et al- concluded that when used appropriately CBT is effective for people with learning disabilities
• means CBT is suitable

Question 9

What is another limitation of CBT in the treatment of depression?

Answer 9

• relapse rates are high
• concerns over how long benefits last
• Ali et al assessed depression in his clients every month for 12 months
  following a course of CBT
• 42% of clients relapsed into depression within 6 months of ending treatment & 53% relapsed within a year
• may need to be repeated periodically